Your Arthroscopic Surgery, A Helpful Guide

Albert G. Volk, MD, FAAOS One Orthopaedic Place St. Augustine, Florida 32086

904.825.0540 Ext. 221 Fax 904.825.0517

[email protected]

ABOUT THE SURGEON

DR. VOLK attended college at The Johns Hopkins University and received his Medical De- gree from Indiana University School of Medicine. He completed his internship and residency program with the University of Southern California Orthopedic Department in Los Angeles, California. While at USC he had the opportunity to learn from and operate with shoulder sur- geon Dr. Frank Jobe at the esteemed Kerlan-Jobe Clinic in Centinela Hospital in Los Angeles, California. Following his residency, Dr. Volk completed a sports medicine shoulder and knee fellowship at the Matthews Orthopedic Clinic, Orlando Regional Medical Center in Orlando, Florida. There Dr. Volk received an additional one year of intensive training in shoulder and knee arthroscopy. He treated professional athletes including professional football, baseball, and basketball players for various sports injuries. Following his one year fellowship, Dr. Volk entered into private practice in St. Augus- tine where he currently resides and practices. He has extensive experience in treating conditions of the shoulder, mostly through arthroscopic procedures. He currently is the Chief Medical Advisor for the Professional Women’s Tennis Associa- tion and continues to evaluate and treat professional players with sports related injuries. He has two board certifications with the American Board of Orthopaedic Surgeons, one in Orthopaedic Surgery and the other in Sports Medicine. WELCOME

Thank you for choosing to have your arthroscopic shoul- en the recovery process. Most surgeries are performed der surgery with Albert G. Volk, MD at Orthopaedic As- on an outpatient surgery basis through three or four tiny sociates of St. Augustine. Our Team of experienced and ˆ˜VˆÃˆœ˜ÃÊV>i`Ê>ÀÌ ÀœÃVœ«ˆVÊ«œÀÌÊ œiðÊÊ/ ˆÃÊÈ}˜ˆwV>˜ÌÞÊ compassionate professionals is dedicated to helping you lessens postoperative pain and facilitates postoperative achieve an improved level of activity and a higher quality rehabilitation with minimal scarring. of life. At Orthopaedic Associates, Dr. Volk has designed a post- Each year over 250,000 people in the United States un- œ«iÀ>̈ÛiÊ Ài >LˆˆÌ>̈œ˜Ê «Àœ}À>“Ê Ì >ÌÊ ˆÃÊ Ã«iVˆwV>ÞÊ Ì>ˆ- dergo shoulder surgery. Candidates for the surgery in- lored to the type of shoulder surgery that you have un- clude those individuals with acute shoulder pain or injury `iÀ}œ˜i°Ê Ê 7 i˜Ê Ì iÀiÊ ˆÃÊ >Ê Ài«>ˆÀÊ œvÊ >Ê ÀœÌ>̜ÀÊ VÕvvÊ œÀÊ >Ê that has severely diminished their ability to perform nor- labrum, this usually entails wearing a postoperative sling mal daily activities without pain. Shoulder surgery can for a period of four to six weeks. The amount of time make a big difference in your ability to return to work, that you will need to recover is highly dependent on the sports, or other activities that you enjoy. procedure you had and on your preoperative physical conditioning. Most arthroscopic shoulder surgery patients recover quickly. New minimally invasive arthroscopic techniques The better your physical condition prior to surgery, the and improved instrumentation have allowed us to quick- quicker and more successful your recovery will be.

MISSION STATEMENT

/ iÊ}œ>ÊœvÊÌ iÊ« ÞÈVˆ>˜ÃÊ>˜`ÊÃÌ>vvÊ>ÌÊ"ÀÌ œ«>i`ˆVÊÃÜVˆ>ÌiÃʜvÊ-ÌÊÕ}ÕÃ̈˜iʈÃÊ>Ü>ÞÃÊÌ iÊÃ>“i\Ê̜ʓ>݈“ˆâiÊ your total movement and performance so you can return to the quality of life you deserve as soon as possible.

THE INTENDED PURPOSE OF THIS GUIDE

UÊÌʈÃʜÕÀÊLiˆivÊÌ >ÌÊ>ÊÜi‡«Ài«>Ài`Ê«>̈i˜ÌÊ>V ˆiÛiÃÊÌ iÊLiÃÌÊÃÕÀ}ˆV>ÊÀiÃՏÌðÊÊ* ÞÈV>Ê«Ài«>À>̈œ˜]Êi`ÕV>̈œ˜]Ê continuity of care, and pre-planned postoperative activities and rehabilitation are important to creating the best results. This guidebook will give you and your caregivers everything you need to know for a rapid return to a healthy and active lifestyle.

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DECISION FOR SURGERY

You and Dr. Volk have decided that the best treatment for your is shoulder arthroscopy.

Depending on the exact procedure and extent of the surgery will dictate:

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"ÀÌ œ«>i`ˆVÊ,i >LˆˆÌ>̈œ˜Êà œÕ`ÊLi}ˆ˜Êœ˜iÊ̜ÊvœÕÀÊ`>ÞÃÊ>vÌiÀÊÃÕÀ}iÀÞ°Ê/ iÊwÀÃÌÊ session is to change your operative dressing and to come up with a plan for your treatment. If your orthopaedic rehabilitation is to be done at a location outside of our facility or through a home health care agency, your physical therapist should call œÕÀʜvwViÊÌœÊ >ÛiÊÌ iʜ«iÀ>̈ÛiÊÀi«œÀÌÊv>Ýi`Ê̜ÊÌ i“°Ê/ ˆÃÊ܈Êˆ˜vœÀ“ÊޜÕÀÊ« ÞÈV>Ê therapist regarding which procedure was performed and what kind of rehabilitation to initiate.

2 Your Arthroscopic Shoulder Surgery WHAT IS A SHOULDER ARTHROSCOPY

Arthro means and scope means to view inside that joint. An arthroscope is a small ˜>ÀÀœÜÊÌÕLiÊÌ >ÌʈÃʈ˜ÃiÀÌi`ʈ˜ÌœÊÌ iÊà œÕ`iÀʍœˆ˜ÌÊÌ ÀœÕ} Ê>Ê«i˜Vˆ‡Ãˆâi`Ê œiÊÌ ÀœÕ} Ê Impingement 1 Ü ˆV Ê>ÊwLiÀʜ«ÌˆVÊV>“iÀ>]ʏˆ} ÌÊÜÕÀVi]Ê>˜`ÊÜ>ÌiÀÊyœÜÊ>ÀiÊ«>ÃÃi`°ÊÊ/ iÊV>“iÀ>ʈÃÊVœ˜- ˜iVÌi`Ê̜Ê>ÊLˆ}ÊÃVÀii˜]Ê ˆ} ‡`iw˜ˆÌˆœ˜ÊÌiiۈȜ˜Ê“œ˜ˆÌœÀ°ÊÊ À°Ê6œŽÊ܈ÊLiÊ>LiÊ̜ÊۈiÜÊ the inside of your shoulder joint and identify frayed, torn, or degenerative tissue.

One or more small incisions are made in the joint for insertion of special instruments used to: Torn Labrum 2 UÊ iLÀˆ`iÊÌ iÊ`i}i˜iÀ>̈ÛiÊ̈ÃÃÕiÊÜʜ˜ÞÊ i>Ì ÞÊ̈ÃÃÕiÊ remains.

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UÊ,i“œÛiÊ>ÀÌ ÀˆÌˆÃÊvÀœ“ÊÌ iÊ Ê­>VÀœ“ˆœV>ۈVՏ>À®Êœˆ˜Ìqq ՓvœÀ`Ê«ÀœVi`ÕÀi°

UÊ,i«>ˆÀʜÀÊÀi>ÌÌ>V ʏˆ}>“i˜ÌÃ]ʏ>LÀՓ]ʜÀʍœˆ˜ÌÊV>«ÃՏiÊvœÀÊÊà œÕ`iÀʈ˜ÃÌ>LˆˆÌÞ°

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New and improved shoulder arthroscopic inventions have led to quicker recovery times, less pain, and faster rehabilitation.

REASONS FOR SHOULDER ARTHROSCOPY

The reasons for shoulder arthroscopy might include: Torn 3 UÊRotator cuff tear - This is the tendon structure of the shoulder that is responsible vœÀʏˆv̈˜}ÊޜÕÀÊ>À“ÊœÛiÀÊޜÕÀÊ i>`°Ê­ˆ}ÕÀiÊή

UÊAdhesive capsulitisʇÊvÀœâi˜Êà œÕ`iÀ°

UÊBicipital tendonitis - frayed or inflamed biceps tendon.

UÊCalcific tendonitis - calcium deposits in the rotator cuff tendon.

UÊHistory of dislocations or subluxation of the shoulder - shoulder instability.

U Labral tears - This is a structure in the shoulder that helps to keep the shoulder in place. The labrum can become frayed, torn, or detached and may need debridement œÀÊÀi«>ˆÀ°Ê­ˆ}ÕÀiÊÓ® and Loose Bodies 4 U Acromioclavicular joint arthritis - The joint between the collar and the acro- “ˆœ˜ÊLiVœ“iÃʈ˜v>“i`ʜÀÊ>ÀÌ ÀˆÌˆV°Ê­ˆ}ÕÀiÊ{®

U Synovitis and - The lining of the joint covering of the tendon becomes ˆ˜v>“i`ʜÀÊÌ ˆVŽi˜i`°Ê­ˆ}ÕÀiÊ£®

U Loose bodies - A piece of can break off the covering of the joint and float vÀiiʈ˜ÊÌ iʍœˆ˜ÌÊV>ÕȘ}ÊV>ÌV ˆ˜}Ê>˜`Ê«>ˆ˜°Ê­ˆ}ÕÀiÊ{®

U Impingement - Usually caused by weakness or narrowing of the space between Ì iÊ Õ“iÀ>Ê i>`Ê>˜`ÊÌ iÊ>VÀœ“ˆœ˜°ÊÊ*>ˆ˜ÊˆÃÊV>ÕÃi`ÊÜ i˜ÊÌ iÊ>À“ʈÃÊÀ>ˆÃi`ʜÛiÀÊ Ì iÊ i>`°Ê­ˆ}ÕÀiÊ£®

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A Helpful Guide 3 HOW TO PREPARE FOR ARTHROSCOPIC SHOULDER SURGERY

UÊ*Ài«>À>̈œ˜ÊvœÀÊÃÕÀ}iÀÞÊLi}ˆ˜ÃÊ>ÃÊܜ˜Ê>ÃÊޜÕÀÊ`œV̜ÀÊÀiVœ“- mends surgery.

UÊ Ü>ÞÃÊ V>ÀÀÞÊ >Ê ˆÃÌÊ œvÊ ÞœÕÀÊ VÕÀÀi˜ÌÊ “i`ˆV>̈œ˜ÃÊ ÜˆÌ Ê ÞœÕ°Ê ÌÊ is very important that we, as your healthcare providers, know what medications you are taking. Your list should include the name of the medication, the dosage of the medication, how many times a day you take the medication, and at what time you take the medication.

UÊ*Àiœ«iÀ>̈ÛiÊVi>À>˜ViʇÊ9œÕÊà œÕ`ʘœÌˆvÞÊޜÕÀÊv>“ˆÞÊ`œV̜ÀÊ of your decision to have surgery. You may need to have an EKG to check the condition of your heart, schedule lab work, or pos- sibly a chest x-ray.

UÊ ÕÀÀi˜Ìʓi`ˆV>̈œ˜ÃʇÊvÊޜÕÊ>ÀiÊVÕÀÀi˜ÌÞÊÌ>Žˆ˜}ÊLœœ`ÊÌ ˆ˜- ˜iÀÃÊÃÕV Ê>ÃÊ>ëˆÀˆ˜]Ê œÕ“>`ˆ˜]Ê*>ۈÝ]ÊۈÌ>“ˆ˜Ê ]Ê>˜Ìˆ‡ˆ˜y>““>̜ÀÞÊ`ÀÕ}ÃÊÃÕV Ê>ÃÊ`ۈÊœÀʏiÛi]ÊޜÕÊ܈Ê˜ii`Ê̜Ê`ˆÃ- cuss with your family doctor when it is safe to stop taking these medications. In most cases, these medications should LiÊÃ̜««i`ÊwÛiÊ̜ÊÃiÛi˜Ê`>ÞÃÊ«ÀˆœÀÊ̜ÊÃÕÀ}iÀÞ°ÊÊiÌÊޜÕÀÊv>“ˆÞÊ`œV̜ÀÊ`iVˆ`iÊiÝ>V̏ÞÊÜ i˜Ê>˜`Ê œÜÊ̜ÊÃ̜«ÊÌ i“°

THE WEEK OF SURGERY

U 9œÕÊ܈Ê LiÊ ÃV i`Տi`Ê >Ê «Àiœ«iÀ>̈ÛiÊ ÛˆÃˆÌÊ >ÌÊ "ÀÌ œ«>i`ˆVÊ ÃÜVˆ>ÌiÃÊ LivœÀiÊ ÞœÕÀÊÃÕÀ}iÀÞ°ÊÊvÊޜÕÊ >ÛiʘœÌÊ>Ài>`ÞÊ}ˆÛi˜ÊœÕÀʜvwViÊ>ʏˆÃÌʜvÊ>ÊœvÊޜÕÀÊVÕÀÀi˜ÌÊ medications, please bring that with you for this visit. Your medical clearance, if needed, should be completed at this time. A note from your family doctor or heart doctor, any lab work, and a recent copy of your EKG should be brought ÜˆÌ ÊޜÕʜÀÊv>Ýi`Ê̜ÊÕÃÊ«ÀˆœÀÊ̜ÊޜÕÀʜvwViÊۈḚ̀ÊÊ

U vÊޜÕÊ`œÊ˜œÌÊ}œÊ̜ÊޜÕÀÊ«Àiœ«iÀ>̈ÛiÊVi>À>˜ViÊ>««œˆ˜Ì“i˜ÌʜÀÊv>ˆÊޜÕÀÊVi>À- ance test, the surgery will be postponed until proper clearance has been ob- Ì>ˆ˜i`°ÊÊ7iÊ܈Ê˜œÌÊ«ÀœVii`Ê>}>ˆ˜ÃÌÊÌ iÊ>`ۈViʜvÊ>˜œÌ iÀÊ`œV̜À°ÊÊ

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U ÌʈÃÊ>ÃœÊˆ“«œÀÌ>˜ÌÊ̜ʘœÌˆvÞÊÕÃʈvÊޜÕÊ >ÛiÊ >`Ê>˜ÞÊ ˆÃ̜ÀÞʜvÊ>˜iÃÌ iÈ>ÊVœ“«ˆ- cations from previous surgeries.

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UÊ Àˆ˜ŽÊ«i˜ÌÞʜvÊÜ>ÌiÀÊ>˜`ʍՈViÃÊÌ iÊÜiiŽÊLivœÀiÊޜÕÀÊÃÕÀ}iÀÞ°ÊÊ

UÊ,i“i“LiÀÊ̜Ê`œÊ>ÊœvÊޜÕÀʏ>ÃÌʓˆ˜ÕÌiÊÀ՘˜ˆ˜}Ê>ÀœÕ˜`Ê̜ܘÊLivœÀiÊÃÕÀ}iÀÞ°ÊÊ9œÕÊ܈Ê˜œÌÊLiÊ>LiÊ̜Ê`ÀˆÛiÊÃ>viÞÊvœÀÊ several weeks after surgery. You will not be able to lift anything after surgery until told by your doctor or physical therapist. Do all of your grocery shopping and important errands the week before surgery.

4 Your Arthroscopic Shoulder Surgery YOUR PREOPERATIVE VISIT WITH US

U 9œÕÊ܈ÊLiÊV iVŽi`ÊvœÀÊΈ˜ÊVœ˜`ˆÌˆœ˜Ãʘi>ÀÊޜÕÀÊà œÕ`iÀ]ÊVœ`Ã]ÊVœÕ} Ã]ÊÊ and fevers.

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U *>ˆ˜Ê>˜`Ê>˜ÌˆLˆœÌˆVÊ«ÀiÃVÀˆ«Ìˆœ˜ÃÊ܈ÊLiÊ}ˆÛi˜Ê>ÌÊÌ ˆÃÊ̈“i°Ê9œÕÊ܈ÊÜ>˜ÌÊ̜ÊwÊ these prescriptions prior to surgery. You do not want to be waiting for your pain medications when you are in pain. Please be sure to get all of your postoperative medications prior to your surgery.

U 9œÕÊ܈ÊÌ>ŽÊ̜ÊÌ iÊ«Àiœ«iÀ>̈ÛiʘÕÀÃiÊÀi}>À`ˆ˜}Ê>˜iÃÌ iÈ>°Ê- iÊ܈Ê}ˆÛiÊ you the approximate time your surgery will be and when to arrive for prepa- À>̈œ˜°Ê*i>ÃiʘœÌi]Ê`ÕiÊ̜ʏ>ÃÌʓˆ˜ÕÌiÊÃV i`ՏiÊV >˜}iÃÊޜÕÀÊÃÕÀ}iÀÞʓ>ÞÊ be earlier or later than anticipated.

U ÌÊÌ ˆÃÊ̈“i]ÊޜÕÊ܈Ê>ÃœÊLiÊ}ˆÛi˜Ê>˜Ê>««œˆ˜Ì“i˜ÌÊ̈“iÊ>˜`Ê`>ÌiÊvœÀÊޜÕÀÊ orthopaedic rehabilitation and postoperative visit with Dr. Volk.

WHAT KIND OF ANESTHESIA WILL I HAVE

U 9œÕÊ܈Ê >ÛiÊ>ÊVœ“Lˆ˜>̈œ˜ÊœvÊ>ÊÀi}ˆœ˜>Êà œÕ`iÀÊLœVŽÊ>˜`Ê}i˜iÀ>Ê>˜iÃÌ iÈ>°Ê œÃÌÊÃÕÀ}iœ˜Ã]Ê>˜iÃÌ iȜœ}ˆÃÌÃ]Ê and patients prefer this. A regional block is called the interscalene block. It will cause everything from your neck to ޜÕÀÊw˜}iÀ̈«ÃÊ̜ÊLiVœ“iʘՓL°

U /i“«œÀ>ÀÞʘՓL˜iÃÃÊvÀœ“ÊÃÕÀ}iÀÞʈÃÊ}œœ`Ê>˜`ʓi>˜ÃÊޜÕÊ܈Ê >ÛiʏiÃÃÊ«>ˆ˜ÊœÀʘœÊ«>ˆ˜Ê՘̈ÊÌ iÊLœVŽÊÜi>ÀÃʜvv°Ê/ iÊ wÀÃÌÊviÜÊ œÕÀÃÊ>vÌiÀÊÃÕÀ}iÀÞÊ>ÀiÊÕÃÕ>ÞÊÌ iʓœÃÌÊ«>ˆ˜vՏ°Ê ÞÊÕȘ}ÊÌ iÊLœVŽÊÜiÊV>˜Ê}iÌÊÌ ÀœÕ} ÊÌ >ÌÊ̈“iÊÜˆÌ ÊˆÌ̏iÊ or no pain.

THE INTERSCALENE BLOCK

The anesthesiologist will clean your neck area with surgical preparation soap. Next they will insert a small thin needle into the side of your neck. A small amount of electricity is used to locate the proper nerve to your shoulder. Once the appropriate nerve is found, the anesthesiologist will inject a local anesthetic into this area. Other medications may be >``i`Ê̜ʈ˜VÀi>ÃiÊÌ iʏi˜}Ì ÊœvÊ̈“iÊÌ >ÌÊÌ iÊLœVŽÊ܈Ê>ÃÌ°ÊÊ7 i˜ÊÌ iÊLœVŽÊˆÃÊVœ“«iÌi`]ÊޜÕÊ܈ÊLiÊÌÀ>˜ÃviÀÀi`ÊÌœÊ the operating room and put into a light sleep for surgery.

A Helpful Guide 5 PREPARE YOUR HOUSE BEFORE SURGERY

UÊÀÀ>˜}iÊvœÀÊܓiœ˜iÊ̜Ê`ÀˆÛiÊޜÕÊ̜Ê>˜`ÊvÀœ“ÊޜÕÀÊÃÕÀ}iÀÞ°ÊÊ9œÕʓ>ÞʘœÌÊLiÊ>LiÊ̜Ê`ÀˆÛiÊÃ>viÞÊvœÀÊÃiÛiÀ>ÊÜiiŽÃÊ after surgery because you will be on pain medication that might affect your judgment. Also, your arm will be in a à œÕ`iÀʈ““œLˆˆâiÀÊ>˜`ÊޜÕʓ>ÞʘœÌÊ >ÛiÊi˜œÕ} ÊÃÌÀi˜}Ì Ê̜Ê`ÀˆÛiÊÜˆÌ Êœ˜iÊ >˜`°

UÊ,i“œÛiÊ>ÊÌ ÀœÜÊÀÕ}ÃÊÌ >ÌÊVœÕ`ÊV>ÕÃiÊޜÕÊ̜ÊÌÀˆ«°

UÊii«Ê >Ü>ÞÃ]ÊLi`Àœœ“Ã]Ê>˜`ÊL>Ì Àœœ“ÃÊvÀiiʜvÊVÕÌÌiÀ°

UÊii«Ê>Ê«œÀÌ>LiÊ« œ˜iʘi>ÀÊޜհ

UÊii«Ê>ʏˆÃÌʜvÊi“iÀ}i˜VÞʘՓLiÀÃÊVœÃiÊLÞ°

UÊ7iÊÃÌÀœ˜}ÞÊÀiVœ““i˜`ÊÏii«ˆ˜}ʈ˜Ê>ʓœÀiÊÕ«Àˆ} ÌÊ«œÃˆÌˆœ˜Ê̜ÊLiÊVœ“vœÀÌ>LiÊ>vÌiÀÊÃÕÀ}iÀÞ°ÊÊ-œ“iÊ«iœ«iÊ«ÀiviÀÊÌœÊ sleep in a recliner, purchase a pillow wedge or use extra pillows to sleep in more of an upright position.

UÊ"LÌ>ˆ˜Ê>ÊviÜʏ>À}iÊLÕÌ̜˜Ê`œÜ˜Êà ˆÀÌðÊ9œÕÊ܈Ê˜œÌÊLiÊ>LiÊ̜ÊÀ>ˆÃiÊޜÕÀÊ>À“ÊœÛiÀÊޜÕÀÊ i>`ÊvœÀÊÃiÛiÀ>ÊÜiiŽÃ°

UÊ*ÕÀV >ÃiʓˆVÀœÜ>Û>LiÊ`ˆ˜˜iÀÃʜÀÊwÝÊޜÕÀÊv>ۜÀˆÌiʓi>ÃÊ>˜`ÊvÀiiâiÊÌ i“ÊvœÀÊvÕÌÕÀiÊÕÃi°Ê

UÊ*Ài«>ÀiÊ i>Ì ÞÊØ>VŽÃÊÌ >ÌÊV>˜ÊLiÊwÝi`ÊÜˆÌ Êœ˜iÊ >˜`ÊÃÕV Ê>ÃÊ>««iÃ]Ê«i>ÀÃ]Ê}À>«iÃ]ÊiÌV°

THE DAY OF YOUR SURGERY

UÊ/ iÊ`>ÞÊ >ÃÊw˜>ÞÊ>ÀÀˆÛi`ÊvœÀÊޜÕÀÊÃÕÀ}iÀÞ°ÊÊ/ iÊÃÌ>vvʈÃÊ ˆ} ÞÊÌÀ>ˆ˜i`ÊvœÀÊ your procedure and for your comfort and safety. Remember, do not eat or drink anything after midnight.

UÊ9œÕʓ>ÞÊÌ>ŽiÊޜÕÀÊ i>ÀÌʜÀÊLœœ`Ê«ÀiÃÃÕÀiʓi`ˆV>̈œ˜ÃÊÜˆÌ ÊÌ iÊÓ>iÃÌÊ >“œÕ˜ÌʜvÊÜ>ÌiÀʘiViÃÃ>ÀÞÊ̜ÊÃÜ>œÜÊޜÕÀÊ«ˆÃ°ÊÊ*i>ÃiÊ`œÊÌ ˆÃÊ>ÌÊÌ iÊ earliest part of the day prior to your surgery.

UÊ/>ŽiÊ>Êà œÜiÀÊLivœÀiÊVœ“ˆ˜}Ê̜ÊÌ iÊÃÕÀ}iÀÞ°

UÊ œÊ˜œÌÊÜi>ÀÊ>˜Þʓ>Ži‡Õ«Ê>˜`ÊÀi“œÛiÊ>Ê˜>ˆÊ«œˆÃ °

UÊ*i>ÃiÊLÀˆ˜}ʏœœÃiÊwÌ̈˜}ÊVœÌ ˆ˜}]ÊiëiVˆ>ÞÊLÕÌ̜˜Ê`œÜ˜Êà ˆÀÌð

UÊvÊޜÕÀÊÃÕÀ}iÀÞʈÃʏ>ÌiÀʈ˜ÊÌ iÊ`>Þ]ÊÃÌ>ÞÊ œ“iʜÀʘi>ÀÊ>Ê« œ˜iʈ˜ÊV>ÃiÊÌ iÀiÊ is a cancellation and we can call you in earlier.

UÊi>ÛiÊ>ÊœvÊޜÕÀʍiÜiÀÞ]ÊÜ>ÌV iÃ]ÊLœ`ÞÊ«ˆiÀVˆ˜}Ã]ÊÜ>iÌ]Ê>˜`Ê«ÕÀÃiÃÊ>ÌÊ home.

UÊ,i“œÛiÊ>Ê«ˆiÀVˆ˜}Ã°Ê iÌ>ÊLœ`ÞÊ«ˆiÀVˆ˜}ÃÊV>˜ÊV>ÕÃiÊLÕÀ˜ÃʈvʏivÌʈ˜°

UÊ*i>ÃiÊ>ÀÀˆÛiʜ˜ÊœÀÊLivœÀiÊÌ iʈ˜ÃÌÀÕVÌi`Ê̈“i°

UÊ,i“œÛiÊ>Ê`i˜ÌÕÀiÃʜÀÊ«>À̈>Ã°ÊÊ

UÊ œÊ˜œÌÊÜi>ÀÊޜÕÀÊVœ˜Ì>VÌʏi˜ÃiÃʜ˜ÊÌ iÊ`>ÞʜvÊޜÕÀÊÃÕÀ}iÀÞ°ÊÊ*i>ÃiÊLÀˆ˜}ÊޜÕÀÊ}>ÃÃið

UÊ9œÕÊ܈ÊLiÊ>Îi`Ê̜Ê}iÌʈ˜ÌœÊ>Ê}œÜ˜ÊvœÀÊÃÕÀ}iÀÞ°

UÊ9œÕÀÊ6Ê܈ÊLiÊÃÌ>ÀÌi`Ê>˜`Ê܈ÊLiÊÕÃi`Ê̜ÊÌÀ>˜Ã«œÀÌÊyՈ`Ê̜ÊޜÕÀÊÛiˆ˜Ã°ÊÊ/ iÃiÊyՈ`ÃÊ܈ÊLiÊÕÃi`ÊvœÀÊÀi>Ý>̈œ˜]Ê̜ʫÕÌÊ you to sleep, to wake you up, to give you pain medications, and to give you antibiotics.

UÊvÌiÀÊÌ iÊ6Ê >ÃÊLii˜ÊÃÌ>ÀÌi`ÊÌ iÊ>˜iÃÌ iȜœ}ˆÃÌÊ܈Ê>`“ˆ˜ˆÃÌiÀÊޜÕÀÊà œÕ`iÀÊLœVŽ°ÊÊ9œÕÀÊLœVŽÊà œÕ`ÊܜÀŽÊvœÀÊ£ÓÊ ÌœÊÓäÊ œÕÀðÊÊ­-iiÊÃiV̈œ˜Êœ˜Êˆ˜ÌiÀÃV>i˜iÊLœVŽ®Ê

6 Your Arthroscopic Shoulder Surgery PAIN CONTROL AFTER SURGERY UÊ9œÕÀÊà œÕ`iÀÊLœVŽÊà œÕ`ʎii«ÊޜÕÊVœ“vœÀÌ>LiÊvœÀÊ£ÓÊ̜ÊÓäÊ œÕÀÃÊ>vÌiÀÊÃÕÀ}iÀÞ°ÊÊ9œÕʓ>ÞʘœÌˆViÊ>ÊviÜÊÌ ˆ˜}ÃÊ>vÌiÀÊ surgery such as:

o The inability to move your shoulder and hand. o Swelling may feel different.

o Your hand and shoulder will be numb. o Your eyelid may droop.

o Your voice may be hoarse.

UÊ/ iÃiÊÃޓ«Ìœ“ÃÊ>ÀiʘœÀ“>Ê>˜`Êà œÕ`ÊÜi>À œvvʈ˜ÊÌ iʘiÝÌÊ£ÓÊ̜ÊÓäÊ œÕÀðÊ9œÕʓ>ÞÊviiÊˆŽiÊޜÕÊV>˜˜œÌÊÌ>ŽiÊ>Ê`ii«Ê LÀi>Ì ]ÊÌ ˆÃʈÃÊ>ÊVœ““œ˜ÊœVVÕÀÀi˜Vi°ÊœÜiÛiÀ]ʈvÊޜÕÊ >ÛiÊà œÀ̘iÃÃʜvÊLÀi>Ì ÊÌ >Ìʏi>`ÃÊ̜ÊÈ}˜ˆwV>˜Ìʏ>LœÀi`ʜÀÊ`ˆv- wVՏÌÞʈ˜ÊLÀi>Ì ˆ˜}]ÊÌ i˜ÊޜÕÊà œÕ`ÊV>ÊÌ iÊ« ÞÈVˆ>˜Êœ˜ÊV>°ÊÊvÊÌ iÊLÀi>Ì ˆ˜}ʈÃÊiÝÌÀi“iÞÊ`ˆvwVՏÌ]ÊޜÕÊà œÕ`ÊV>Ê ™££ÊœÀÊ«ÀœVii`Ê̜ÊÌ iʘi>ÀiÃÌÊi“iÀ}i˜VÞÊÀœœ“°ÊÊ

UÊ7iÊÀiVœ““i˜`ÊÌ >ÌÊޜÕÊÀiÃÌÊ>vÌiÀÊÃÕÀ}iÀÞ°ÊÊvÊޜÕÀÊLœVŽÊÃÌ>ÀÌÃÊ̜ÊÜi>ÀʜvvÊ>ÌÊÓÊ>°“°]ÊÌ i˜ÊޜÕÊ >ÛiÊ>Ài>`ÞÊ >`Êiˆ} ÌÊ hours of sleep.

UÊ7 i˜ÊÌ iÊLœVŽÊÃÌ>ÀÌÃÊ̜ÊÜi>ÀʜvvÊ>˜`ÊޜÕÊ>ÀiÊLi}ˆ˜˜ˆ˜}Ê̜ÊviiÊ>ʏˆÌ̏iÊ՘Vœ“vœÀÌ>Li]ÊޜÕʓ>ÞÊLi}ˆ˜Ê̜ÊÌ>ŽiÊޜÕÀÊ pain medication that has been prescribed for your surgery. Do not wait for your block to completely wear off because Ì iÊ«>ˆ˜ÊVœ˜ÌÀœÊV>˜ÊLiʓœÀiÊ`ˆvwVՏ̰

AFTER SURGERY

UÊ9œÕÊ܈ÊÜ>ŽiÊիʈ˜ÊÌ iÊÀiVœÛiÀÞÊÀœœ“ÊÜˆÌ ÊޜÕÀÊ`ÀiÃȘ}Ê>˜`Êà œÕ`iÀʈ““œLˆ- ˆâiÀʈ˜Ê«>Vi°ÊÊ*i>Ãiʏi>ÛiÊÌ iÊ`ÀiÃȘ}Ê>˜`Êà œÕ`iÀʈ““œLˆˆâiÀʜ˜Ê՘̈ÊޜÕÀÊ wÀÃÌʜÀÌ œ«>i`ˆVÊÀi >LˆˆÌ>̈œ˜Ê“iï˜}Ê­ÕÃÕ>Þʈ˜Êœ˜iÊ̜ÊÌ ÀiiÊ`>Þî°ÊÊ

UÊ9œÕÀÊwÀÃÌʜvwViÊ>««œˆ˜Ì“i˜ÌÊ܈ÊLiÊ>««ÀœÝˆ“>ÌiÞÊ£ÓÊ`>ÞÃÊvœœÜˆ˜}ÊޜÕÀÊÃÕÀ}iÀÞ°ÊÊ At that time we will take out your sutures, explain your surgery and show you the operative pictures. Your exact procedure and restrictions will be given to you.

ORTHOPAEDIC REHABILITATION

UÊ9œÕÀÊwÀÃÌʜÀÌ œ«>i`ˆVÊÀi >LˆˆÌ>̈œ˜ÊÃiÃȜ˜Ê܈ÊLiʜ˜iÊ̜ÊÌ ÀiiÊ`>ÞÃÊ>vÌiÀÊޜÕÀÊ surgery.

UÊ ivœÀiÊÃÕÀ}iÀÞʓ>ŽiÊÃÕÀiÊÌ >ÌÊޜÕÀʈ˜ÃÕÀ>˜ViÊVœ“«>˜ÞʜÀÊ7œÀŽiÀÃ½Ê œ“«i˜Ã>- tion carrier approves the payment for your rehabilitation at the facility where you will be having it.

UÊ9œÕÀÊiÝ>VÌÊiÝiÀVˆÃiÃÊ>˜`ÊÀiÃÌÀˆV̈œ˜ÃÊ܈ÊLiÊ>VVœÀ`ˆ˜}Ê̜ÊÌ iÊëiVˆwVÊÃÕÀ}iÀÞÊÌ >ÌÊޜÕÊ >`Ê«iÀvœÀ“i`°

WHAT TYPE OF ORTHOPAEDIC REHABILITATION WILL I NEED?

Shoulder Arthroscopy Without Repair

If you have had any of the following surgeries without any type of repair:

UÊ iLÀˆ`i“i˜ÌʜvÊ>Ê«>À̈>ÊÀœÌ>̜ÀÊVÕvvÊÌi>ÀʇÊV>VˆwVÊÌi˜`œ˜ˆÌˆÃ]ʏ>LÀÕ“Ê or biceps tendon.

UÊ Õ“vœÀ`ÊÊ«ÀœVi`ÕÀiʇÊÀiÃiV̈œ˜ÊœvÊÌ iÊ`ˆÃÌ>ÊV>ۈVi°

UÊ-ÕL>VÀœ“ˆ>Ê`iVœ“«ÀiÃȜ˜Ê‡Ê}ˆÛˆ˜}ÊޜÕʓœÀiÊë>ViÊLiÌÜii˜ÊÌ iÊ top of the humeral head and the undersurface of the acromion.

UÊ-ޘœÛiV̜“ÞʜÀÊLÕÀÃiV̜“ÞʇÊÀi“œÛˆ˜}ʈ˜y>“i`Ê̈ÃÃÕiÊvÀœ“ʈ˜Ãˆ`iÊ the shoulder.

A Helpful Guide 7 1 First six œÀÊ>˜ÞÊÌ iÃiÊ«ÀœVi`ÕÀiÃ]ÊޜÕÊ܈ÊÕÃiÊޜÕÀÊà œÕ`iÀʈ““œLˆˆâiÀÊvœÀÊVœ“vœÀÌÊ and can discontinue it whenever you feel comfortable. This is typically any- weeks where from seven to ten days after the surgery.

Early pendulum exercises and passive range of motion will be performed `ÕÀˆ˜}ÊÌ iÊwÀÃÌÊÜiiŽ°ÊÊ/ ˆÃÊ܈ÊiÛi˜ÌÕ>ÞÊ«Àœ}ÀiÃÃÊ̜Ê>V̈ÛiÊÀ>˜}iʜvʓœÌˆœ˜Ê and active strengthening exercises when comfortable, which usually takes two to three weeks from the date of your surgery.

Arthroscopic Rotator Cuff Repair

If an arthroscopic rotator cuff repair was performed then your postoperative activity and restrictions will be as follows:

U / iÊ wÀÃÌÊ ÃˆÝÊ ÜiiŽÃÊ ÞœÕÊ ÜˆÊ LiÊ ÀiµÕˆÀi`Ê ÌœÊ Üi>ÀÊ >Ê Ãˆ˜}Ê >˜`Ê `œÊ «>ÃÈÛiÊ 2 external rotation stretches as tolerated, with your elbow at your side to Week 7 - 12 >V ˆiÛiÊ>Ìʏi>ÃÌÊ{xcʜvÊiÝÌiÀ˜>ÊÀœÌ>̈œ˜°ÊÊ­-iiʈ}ÕÀiÊ£® U 9œÕÊ܈ÊLiÊÀiµÕˆÀi`Ê̜ÊÜi>ÀÊÌ iÊψ˜}Ê`>ÞÊ>˜`ʘˆ} Ì]ʈ˜VÕ`ˆ˜}ÊÏii«ˆ˜}ÊvœÀÊ Ì iÊwÀÃÌÊÌ ÀiiÊÜiiŽÃ°Ê

U / iÊÃiVœ˜`ÊÌ ÀiiÊÜiiŽÃÊÜiÊ܈ÊÀiµÕˆÀiÊÌ >ÌÊޜÕÊÜi>ÀÊÌ iÊψ˜}Ê`ÕÀˆ˜}ÊÌ iÊ `>ÞÊ̈“iÊ>˜`ʓœÃÌÊ`iw˜ˆÌiÞʈvÊޜÕÊ>ÀiÊÜ>Žˆ˜}Ê>ÀœÕ˜`ÊÌ iÊ œÕÃiʜÀʈvÊޜÕÊ go outside of your house. If you are sitting inactive, you may take off the sling keeping your elbow at your side. You may discontinue the pillow por- ̈œ˜ÊœvÊÌ iÊψ˜}Ê>vÌiÀÊÎÊÜiiŽÃ°

U 7iiŽÃÊÇÊÌ ÀœÕ} Ê£ÓÊޜÕʓ>ÞÊLi}ˆ˜Ê«>ÃÈÛiÊiiÛ>̈œ˜ÊœvÊޜÕÀÊà œÕ`iÀÊ>ÃÊ ÌœiÀ>Ìi`°ÊÊ/ iÊÌ iÀ>«ˆÃÌÊ܈Ê>ÃÈÃÌÊޜÕÊÜˆÌ ÊÛ>ÀˆœÕÃÊiÝiÀVˆÃiðʭ-iiʈ}ÕÀiÊ Ó®

U 7iiŽÊ£ÎÊ>˜`ÊÌ iÀi>vÌiÀÊޜÕÊ܈ÊLi}ˆ˜Ê>ÊÃÌÀi˜}Ì i˜ˆ˜}Ê«Àœ}À>“ʈ˜ÊœÀÌ œ- paedic rehabilitation using a / iÀ>‡ >˜`Á and weights. ­-iiʈ}ÕÀiÃÊÎÊEÊ{® 3 Week 13 & Thereafter UʘÊV>ÃiʜvÊ>ÊÀiۈȜ˜ÊÀœÌ>̜ÀÊVÕvvÊÀi«>ˆÀʜÀʓ>ÃÈÛiÊÀœÌ>̜ÀÊVÕvvÊÀi«>ˆÀÊ­}Ài>Ì- iÀÊÌ >˜ÊxÊV“ʈ˜Ê`ˆ>“iÌiÀ®]ÊÜiÊÌÞ«ˆV>ÞÊ`œÊ˜œÌÊ>œÜÊޜÕÊ̜Ê`ˆÃVœ˜Ìˆ˜ÕiÊÌ iÊ sling until eight weeks after your surgery and do not begin strengthening ՘̈Ê£ÇÊÜiiŽÃÊ­vœÕÀʓœ˜Ì îÊ>vÌiÀÊÌ iÊÃÕÀ}iÀÞ°ÊÊ

UÊ œ˜Ì ÊÈÝÊ>˜`ÊÌ iÀi>vÌiÀÊޜÕʓ>ÞÊÀiÃՓiÊvՏÊ՘ÀiÃÌÀˆVÌi`Ê>V̈ۈÌÞʈvÊÌ ˆÃʈÃÊ a primary repair and is less than 5 cm in diameter. If it is a revision repair or >ÃÊ>Ê`ˆ>“iÌiÀʜvÊ}Ài>ÌiÀÊÌ >˜ÊxÊV“]ÊÜiÊ܈Ê >ÛiÊޜÕÊÜ>ˆÌÊ՘̈Ê£Óʓœ˜Ì ÃÊ postoperative to resume full unrestricted activity, which could include golf or overhead sports.

Arthroscopic Biceps Tenodesis 4 Week 13 & Thereafter If this is performed without a repair of the rotator cuff, then the same proto- VœÊvœÀÊÌ iÊ-*ʏiȜ˜ÊÀi«>ˆÀʈÃÊvœœÜi`Ê­ÃiiÊ-*ʏiȜ˜ÊÀi«>ˆÀÊ«ÀœÌœVœ®°Ê If this is performed with a rotator cuff repair, then the same protocol is used vœÀÊ>ÊÀœÌ>̜ÀÊVÕvvÊÀi«>ˆÀÊ­ÃiiÊÀœÌ>̜ÀÊVÕvvÊÀi«>ˆÀÊ«ÀœÌœVœ®°

Arthroscopic Repair of Subscapularis Tendon

vÊÜiÊÀi«>ˆÀÊÌ ˆÃÊëiVˆwVÊ«>ÀÌʜvÊޜÕÀÊÀœÌ>̜ÀÊVÕvvʈ˜ÊÌ iÊvÀœ˜ÌʜvÊޜÕÀÊà œÕ`iÀÊ called the subscapularis muscle, certain exceptions to the rotator cuff proto- VœÊ܈Ê>««Þ°Ê/ ˆÃʈ˜VÕ`iÃÊiÝÌiÀ˜>ÊÀœÌ>̈œ˜ÊÀiÃÌÀˆVÌi`Ê̜ÊäcÊvœÀÊÌ iÊwÀÃÌÊÈÝÊ weeks and then increased as tolerated.

8 Your Arthroscopic Shoulder Surgery Arthroscopic Anterior Instability Repair

If we perform surgery to correct a dislocating shoulder, the following restrictions and activities apply:

U 7iiŽÊœ˜iÊÌ ÀœÕ} ÊvœÕÀÊޜÕÊ>ÀiÊ̜ÊÜi>ÀÊ>Êψ˜}ÊvՏÊ̈“iÊ>˜`Ê܈ÊLiÊi˜VœÕÀ>}i`Ê̜ÊiÝÌiÀ˜>ÞÊÀœÌ>ÌiÊÌ iÊ>À“Êœ˜ÞÊäcÊ ­Ì iÊÃÌÀ>ˆ} ÌÊ> i>`Ê«œÃˆÌˆœ˜®°

U vÌiÀÊvœÕÀÊÜiiŽÃÊÌ iÊψ˜}ʈÃÊ`ˆÃVœ˜Ìˆ˜Õi`Ê>˜`ÊޜÕÊ܈ÊLiÊ>œÜi`ʜÛiÀ i>`ÊÃÌÀiÌV ˆ˜}Ê>V̈ۈÌÞÊÕȘ}Ê>ÊÀœ«iÊ>˜`ʫՏiÞÊ in orthopaedic rehabilitation.

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Arthroscopic Superior Labrum Anterior-Posterior (SLAP) Repair

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U œÀÊÌ iÊwÀÃÌÊvœÕÀÊÜiiŽÃ]ÊޜÕÊ܈ÊLiÊÀiµÕˆÀi`Ê̜ÊÜi>ÀÊÌ iÊψ˜}Ê>ÌÊ>Ê̈“ið

U ÕÀˆ˜}ÊÌ œÃiÊvœÕÀÊÜiiŽÃ]ÊޜÕÊ܈ÊLiÊÕÀ}i`Ê̜ʫiÀvœÀ“ÊiÝÌiÀ˜>ÊÀœÌ>̈œ˜ÊÃÌÀiÌV iÃÊ>ÃÊv>ÀÊ>ÃÊ«œÃÈLiÆÊÜˆÌ ÊޜÕÀÊ}œ>Ê being to try and match the external rotation of the side that was not operated on by the end of four weeks.

U vÌiÀÊvœÕÀÊÜiiŽÃÊÌ iÊψ˜}Ê܈ÊLiÊ`ˆÃVœ˜Ìˆ˜Õi`°ÊÊÌÊÌ ˆÃÊ«œˆ˜Ì]ÊޜÕÊV>˜ÊLi}ˆ˜ÊœÛiÀ i>`ÊÃÌÀiÌV ˆ˜}Ê>˜`ÊVœ˜Ìˆ˜ÕiÊÜˆÌ Ê passive external rotation stretches.

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U vÊޜÕÊiÝ«iÀˆi˜ViÊ«>ˆ˜ÊÜˆÌ ÊÀiÈÃÌi`ÊvœÀÜ>À`Êyi݈œ˜ÊœvÊÌ iÊ>À“Ê>ÌÊÈÝÊÜiiŽÃÊ«œÃ̜«iÀ>̈ÛiÞ]ÊÜiÊ܈Ê`i>ÞÊLˆVi«ÃÊVÕÀÃÊ until eight weeks postoperatively.

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U ÌÊ ÃiÛi˜Ê “œ˜Ì ÃÊ «œÃ̜«iÀ>̈ÛiÞÊ ÞœÕÊ V>˜Ê Li}ˆ˜Ê ÌœÊ ÀiÌÕÀ˜Ê ÌœÊ vՏÊ >˜`Ê Õ˜ÀiÃÌÀˆVÌi`Ê >V̈ۈÌÞ]Ê ˆ˜VÕ`ˆ˜}Ê >Ê œÛiÀ i>`Ê sports.

SOME POSTOPERATIVE EXCEPTIONS

Calcific Tendonitis

*>̈i˜ÌÃÊÜ œÊ >ÛiÊ>ÀÌ ÀœÃVœ«ˆVÊÃÕÀ}iÀÞÊ̜ÊÀi“œÛiÊV>VˆÕ“Ê`i«œÃˆÌÃʈ˜ÊÌ iÊÀœÌ>̜ÀÊVÕvvÊÌi˜`Ê̜ÊLiVœ“iʓœÀiʈ˜y>“i`Ê and stiff after surgery. Therefore we start immediate postoperative stretching, including passive elevation with a rope and pulley and passive external and internal rotation.

SLAP Lesion Repair in Association with Small

7iÊ >ÛiÊvœÕ˜`ÊÌ >Ìʈ˜Ê}i˜iÀ>]Ê«iœ«iÊÜ œÊ >ÛiÊÌ iÃiÊÌܜʫÀœVi`ÕÀiÃÊÌi˜`Ê̜Ê`iÛiœ«Ê“œÀiÊ«œÃ̜«iÀ>̈ÛiÊÃ̈vv˜iÃÃÊ and therefore we now start immediate passive forward elevation as well as passive internal and external rotation.

A Helpful Guide 9 POSSIBLE COMPLICATIONS

U Ì œÕ} ÊÌ iÊ«œÃÈLˆˆÌÞʜvÊVœ“«ˆV>̈œ˜ÃʈÃʏœÜ]ʈvÊÌ iÞʜVVÕÀÊÌ iÞÊV>˜ÊLiÊÛiÀÞÊÃiÀˆœÕðÊÊ*i>ÃiÊVœ˜Ì>VÌÊÕÃÊ>ÌÊ>˜ÞÊ̈“iÊ >ÌÊ­™ä{®ÊnÓ5‡äx{ä°Ê,i“i“LiÀ]ʜÕÀÊAfter Hours Injury ClinicʈÃʜ«i˜Ê՘̈Ê£ä\ääÊ«°“°Êœ˜ÊÜiiŽ˜ˆ} ÌÃÊ>˜`ʜ˜Ê->ÌÕÀ`>ÞÃÊ vÀœ“Ê™\ääÊ>°“°Ê՘̈ÊÇ\ääÊ«°“°Ê7iÊ>ÀiÊVœÃi`ʜ˜Ê-՘`>Þ°Ê

U œ“«ˆV>̈œ˜Ãʓ>Þʈ˜VÕ`i\ÊiÝViÃÈÛiÊLii`ˆ˜}]ʘiÀÛiʈ˜ÕÀÞ]ʈ˜viV̈œ˜]ÊÃÜiˆ˜}ʈ˜ÊÌ iʘiVŽÊœÀÊv>Vi]Ê«iÀÈÃÌi˜ÌÊ >˜`Ê numbness, bruising of the arm, stiffness and recurrent tears of repaired structures.

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REASONS TO CALL THE DOCTOR

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UʘÞÊÃiÛiÀiÊÀi`˜iÃÃʜÀÊ`À>ˆ˜>}iÊ>ÌÊÌ iʈ˜VˆÃˆœ˜ÊœÀÊÌ iʈ˜VˆÃˆœ˜Ê`œiÃʘœÌÊÃi>ÊÕ«Ê>vÌiÀÊÌ iÊÃÕÌÕÀiÃÊ >ÛiÊLii˜ÊÀi“œÛi`°

UÊvÊÌ iÀiʈÃÊ>ÊÜ ˆÌiʜÀÊÞiœÜˆÃ Ê`À>ˆ˜>}iÊVœ“ˆ˜}ÊvÀœ“Ê>˜ÞʜvÊÌ iʈ˜VˆÃˆœ˜Ã°

SUMMARY

This preoperative brochure is meant to:

UÊ `ÕV>Ìi°

UÊ ˜VœÕÀ>}i°

UÊ “«œÜiÀʜÕÀÊ«>̈i˜ÌÃÊ̜ÊÃ>viÞÊÀi>V ÊÌ iˆÀÊ}œ>ÃÊ>ÃʵՈVŽÞÊ>ÃÊ«œÃÈLi°

GOALS

UÊ/œÊLiÊ>ÃÊ«>ˆ˜ÊvÀiiÊ>˜`ÊÃÌÀœ˜}Ê>ÃÊ«œÃÈLiÊÜÊÌ >ÌÊޜÕÊV>˜ÊÀiÌÕÀ˜Ê̜\

o Your sport.

o Your activities of daily living.

o The quality of life you deserve.

THANK YOU

/ >˜ŽÊޜÕÊvœÀÊi˜ÌÀÕÃ̈˜}ÊÕÃÊÜˆÌ ÊޜÕÀÊV>Ài°ÊÊ7iÊ܈Ê`œÊiÛiÀÞÌ ˆ˜}Ê«œÃÈLiÊ̜ʓ>ˆ˜Ì>ˆ˜ÊޜÕÀÊÌÀÕÃÌÊ>˜`ÊVœ˜w`i˜Vi°Ê vÊޜÕÊ >ÛiÊ>˜ÞʵÕiÃ̈œ˜ÃÊ«i>ÃiÊV>ÊÕÃÊ­™ä{®ÊnÓx‡äx{ä°

10 YAthiShldSYour Arthroscopic Shoulder Surgery FREQUENTLY ASKED QUESTIONS

HOW SUCCESSFUL IS THE SURGERY? If a repair is performed, expect:

˜Ê }i˜iÀ>]Ê >ÀÌ ÀœÃVœ«ˆVÊ ÃÕÀ}iÀÞÊ œvÊ Ì iÊ Ã œÕ`iÀÊ ˆÃÊ nxÊ UÊ-ˆÌ̈˜}Ê`iÎʍœLÊqÊÓÊ̜ÊÎÊÜiiŽÃ -95% successful, depending on the complexity of the op- UÊ"˜ÊޜÕÊviiÌʍœLÊqÊÎÊ̜ÊÈÊÜiiŽÃ eration and adherence to the postoperative rehabilitation Uʈ} Ê`i“>˜`ʍœLÊqÊÓÊ̜Ê{ʓœ˜Ì ÃÊ «ÀœÌœVœ°Ê*œœÀʜÕÌVœ“iÃÊ >ÛiÊLii˜Ê>ÃÜVˆ>Ìi`ÊÜˆÌ \Ê WHEN CAN I DRIVE? U *œœÀÊ̈ÃÃÕiʵÕ>ˆÌÞ° U >À}iʜÀʓ>ÃÈÛiÊÌi>ÀÃ°Ê }>ˆ˜]Ê Ì ˆÃÊ `i«i˜`ÃÊ œ˜Ê >Ê Ài«>ˆÀÊ ÛiÀÃÕÃÊ ˜œÊ Ài«>ˆÀ°Ê 7ˆÌ Ê U *œœÀÊVœ“«ˆ>˜ViÊÜˆÌ Ê«œÃ̜«iÀ>̈ÛiÊÀi >LˆˆÌ>̈œ˜Ê>˜`Ê ˜œÊÀi«>ˆÀ]ÊޜÕÊ܈ÊLiÊ>LiÊ̜Ê`ÀˆÛiʈ˜Ê£‡ÓÊÜiiŽÃ°Ê7ˆÌ Ê>Ê restriction. Ài«>ˆÀ]ÊޜÕÊV>˜ÊiÝ«iVÌÊ̜ÊÀiÌÕÀ˜Ê̜Ê`ÀˆÛˆ˜}ÊvÀœ“ÊӇÈÊÜiiŽÃÊ U *>̈i˜ÌÊ>}iÊ­œ`iÀÊÌ >˜ÊÈxÊÞi>Àî°Ê following your surgery. This will depend on the extent of the repair and the frequency and distance you need to WHAT ARE THE COMPLICATIONS AND FREQUENCY? `ÀˆÛi]Ê>ÃÊÜiÊ>ÃÊޜÕÀÊVœ˜w`i˜ViʏiÛi°

Fortunately, complications from shoulder surgery are in- HOW LONG DO I HAVE TO WEAR THE SLING? frequent, and those from arthroscopic surgery are even iÃÃÊ Vœ““œ˜°Ê / iÃiÊ ˆ˜VÕ`iÊ ­ÜˆÌ Ê vÀiµÕi˜VÞÊ œvÊ œVVÕÀ- 7ˆÌ œÕÌÊ>˜ÞÊÌÞ«iʜvÊÀi«>ˆÀÊޜÕÊV>˜Ê`ˆÃVœ˜Ìˆ˜ÕiÊÌ iÊψ˜}Ê Ài˜Vi®\Ê as soon as you are comfortable without it. This can be >˜ÞÜ iÀiÊ vÀœ“Ê xÊ `>ÞÃÊ ÌœÊ ÓÊ ÜiiŽÃ°Ê Ê 7ˆÌ Ê >Ê Ài«>ˆÀ]Ê ÜiÊ £°Ê iÀÛiʈ˜ÕÀÞÊ­£Ê«iÀVi˜Ì®\Ê/ ˆÃÊÀ>ÀiÞʜVVÕÀÃÊvœÀÊÀi«>ˆÀÊ }i˜iÀ>ÞÊ >ÛiÊޜÕÊÜi>ÀÊÌ iÊψ˜}Ê>ÊœvÊÌ iÊ̈“iÊ­iÝVi«ÌÊ of massive rotator cuff tears, where soft-tissue releases à œÜiÀˆ˜}®ÊvœÀÊÌ iÊwÀÃÌÊÎÊÜiiŽÃ°Ê/ i˜ÊvÀœ“ÊÜiiŽÊÎʇÈÊޜÕÊ are necessary and there is a potential for stretching the only need to wear the sling if you are up walking around nerves. the house or you go outside of the house. Those with massive rotator cuff repairs need to wear the sling up to ӰʘviV̈œ˜Ê­iÃÃÊÌ >˜Ê£Ê«iÀVi˜Ì®\Ê1ÃiʜvÊ>˜ÌˆLˆœÌˆVÃÊ`ÕÀˆ˜}Ê nÊÜiiŽÃÊ>vÌiÀÊÃÕÀ}iÀÞ° the procedure and sterile surgical technique limit the risk of infection. DO I HAVE TO WEAR THE SLING AT NIGHT?

ΰÊ-̈vv˜iÃÃÊ­iÃÃÊÌ >˜Ê£Ê«iÀVi˜Ì®\Ê >ÀÞÊÀi >LˆˆÌ>̈œ˜Ê«Àœ- 7ˆÌ œÕÌÊ>˜ÞÊÀi«>ˆÀ]ÊޜÕÊ`œÊ˜œÌʘii`Ê̜ÊÜi>ÀÊÌ iÊψ˜}Ê>ÌÊ tocols decrease the likelihood of permanent stiffness or ˜ˆ} Ì°Ê7ˆÌ Ê>ÊÀi«>ˆÀ]ÊÜiÊÜ>˜ÌÊޜÕÊ̜ÊÜi>ÀÊÌ iÊψ˜}ÊÜˆÌ Ê loss of motion following a rotator cuff repair. This also less Ì iÊ«ˆœÜÊvœÀÊÌ iÊwÀÃÌÊÎÊÜiiŽÃÊ>vÌiÀÊÃÕÀ}iÀÞ°ÊvÌiÀÊÌ >Ì]Ê frequent with arthroscopic procedures. ˆÌ½ÃÊÕ«Ê̜ÊޜհÊ-œ“iÊ«iœ«iÊw˜`ʈÌʓœÀiÊVœ“vœÀÌ>LiÊÌœÊ Üi>ÀÊÌ iÊψ˜}Ê>Ìʘˆ} ÌÊLiޜ˜`ÊÌ iÊÎÊÜiiŽÃ]ÊiëiVˆ>ÞʈvÊ {°Ê/i˜`œ˜ÊÀi‡Ìi>ÀÊ­ÈÊ«iÀVi˜Ì®\Ê-iÛiÀ>ÊÃÌÕ`ˆiÃÊ >ÛiÊ`œVÕ- Ì iÞÊ>ÀiÊÀiÃ̏iÃÃÊÏii«iÀðʏÜ]ÊvœÀÊÌ iÊwÀÃÌÊÃiÛiÀ>Ê˜ˆ} ÌÃÊ mented tearing of the rotator cuff following all types of >vÌiÀÊÌ iÊÃÕÀ}iÀÞ]ÊܓiÊ«iœ«iÊw˜`ʈÌʓœÀiÊVœ“vœÀÌ>LiÊ repairs. It appears that tendon re-tear does not guaran- to sleep in an upright position or in a recliner chair. tee a poor result, return of pain, or poor function. WHERE CAN I GET MORE INFORMATION? WHEN CAN I SHOWER? *i>ÃiÊviiÊvÀiiÊ̜ÊV>Ê>˜`Ê>ÎʵÕiÃ̈œ˜ÃÊ>ÌÊ>˜ÞÊ̈“i°Ê9œÕÊ i˜iÀ>ÞʓœÃÌÊ«iœ«iÊ>ÀiÊ>LiÊ̜Êà œÜiÀÊӇÎÊ`>ÞÃÊ>vÌiÀÊ V>˜Êw˜`ʓœÀiʈ˜vœÀ“>̈œ˜Êœ˜Êˆ˜iÊ>Ì\ÊÊÜÜÜ°œ>ÃÌ>Õ}°Vœ“ Ì iÊÃÕÀ}iÀÞ°Ê/ ˆÃʈÃÊÕÃÕ>ÞÊ>vÌiÀÊÌ iÊwÀÃÌÊ`ÀiÃȘ}ÊV >˜}iÊ or www.orthoinfo.aaos.org. >ÌÊ œÀÌ œ«>i`ˆVÊ Ài >LˆˆÌ>̈œ˜°Ê 7iÊ >ÃŽÊ ÞœÕÊ ÌœÊ Žii«Ê Ì iÊ incisions dry with waterproof adhesive bandages and or plastic wrap and tape. Also, it is important that you do ˜œÌÊÃÕL“iÀ}iÊÌ iʈ˜VˆÃˆœ˜Ãʈ˜ÊÜ>ÌiÀÊ­ÌÕLʜÀÊ«œœ®Ê՘̈Ê>ÌÊ i>ÃÌÊ{nÊ œÕÀÃÊ>vÌiÀÊÌ iÊÃÕÌÕÀiÃÊ>ÀiÊÌ>Ži˜ÊœÕÌÊ­ÓÊÜiiŽÃÊ >vÌiÀÊÃÕÀ}iÀÞ®°

WHEN CAN I GO BACK TO WORK?

This of course depends on what type of work you do and what type of surgery you have. In general, for arthroscop- ic surgery without any type of repair:

UÊ-ˆÌ̈˜}Ê`iÎʍœLÊqÊ£Ê̜ÊÓÊÜiiŽÃ UÊ"˜ÊޜÕÀÊviiÌʍœLÊqÊÓÊ̜Ê{ÊÜiiŽÃ Uʈ} Ê`i“>˜`ʍœLÊÀiµÕˆÀˆ˜}ʜÛiÀ i>`Ê>V̈ۈÌÞÊqÊÈÊ̜ÊnÊ weeks (L-R) Albert Volk, MD; Patrick Thompson, PA-C, MPAS; Arlow Bailey, OPA-C

AAH Helpfull f l GuideG id 11 IT TAKES A JOINT TASK FORCE TO PROVIDE QUALITY POST-OP CARE

Count on on Welcome Welcome Homecare’s Homecare’s award-winning award-winning staff to continue staff tothe expert continuecare you require the expert to recuperate care you at home.require Our to programsrecuperate help at preventhome. Ourinfections, programs helpenhance prevent healing, infection, and restore enhance maximum healing, mobility and – allrestore in the maximum comfort of mobilityyour home. – all in the comfort of your home. Welcome Homecare’s Advantages: JACKSONVILLE .... 904-727-9624 JACKSONVILLELIC# HHA21285096 ...... 904-727-9624FAX: 904-720-0059 U Compassionate nurses certified in advanced wound-care, LIC# HHA21285096 ...... FAX: 904-720-0059 diabetic cardiac protocols and medication management ORANGE PARK .... 904-272-5044 LIC# HHA21789096 ...... FAX: 904-269-2485 U Supervision by your orthopedic surgeon ORANGE PARK .... 904-272-5044 LIC# HHA21789096 ...... FAX: 904-269-2485 U One-to-one care by licensed Physical Therapists ST. AUGUSTINE.... 904-461-0461 LIC# HHA299991624 ...... FAX: 904-461-0468 U Seamless integration between surgical team and ST. AUGUSTINE.... 904-461-0461 Welcome Homecare LIC#FER HHA299991624NANDINA...... 904-277-8330FAX: 904-461-0468 LIC# HHA21790096 ...... FAX: 904-277-7923 U Advanced technologies used in healing, tracking FERNANDINA ...... 904-277-8330 and communications LIC#MACCLENNY HHA21790096 ...... 904-259-3111FAX: 904-277-7923 LIC# HHA217880961 ...... FAX: 904-259-5176 MACCLENNY ...... 904-259-3111 PALM COAST ...... 866-461-0461 LIC# HHA217880961 ...... FAX: 904-259-5176 LIC# HHA299991624 ...... FAX: 866-461-0468 PALM COAST ...... 866-461-0461 LIC# HHA299991624 ...... FAX: 866-461-0468

We deliver better than anyone We offer you and your patients a full range of post-operative therapies delivered directly to your patients, wherever they are. • Orthopedic Bracing • Continuous Passive Motion • Cold Therapy • Compression Therapy Systems • TENS/NMES Electric       Stimulation                     One number delivers it all! 1.800.RENT.CPM